Adherence, adaptation and acceptance of elderly chronic heart failure patients to receiving healthcare via telephone-monitoring

Background: Although the potential to reduce hospitalisation and mortality in chronic heart failure (CHF) is well reported, the feasibility of receiving healthcare by structured telephone support or telemonitoring is not. Aims: To determine; adherence, adaptation and acceptability to a national nurse-coordinated telephone-monitoring CHF management strategy. The Chronic Heart Failure Assistance by Telephone Study (CHAT). Methods: Triangulation of descriptive statistics, feedback surveys and qualitative analysis of clinical notes. Cohort comprised of standard care plus intervention (SC + I) participants who completed the first year of the study. Results: 30 GPs (70% rural) randomised to SC + I recruited 79 eligible participants, of whom 60 (76%) completed the full 12 month follow-up period. During this time 3619 calls were made into the CHAT system (mean 45.81 SD ± 79.26, range 0-369), Overall there was an adherence to the study protocol of 65.8% (95% CI 0.54-0.75; p = 0.001) however, of the 60 participants who completed the 12 month follow-up period the adherence was significantly higher at 92.3% (95% CI 0.82-0.97, p ≤ 0.001). Only 3% of this elderly group (mean age 74.7 ±9.3 years) were unable to learn or competently use the technology. Participants rated CHAT with a total acceptability rate of 76.45%. Conclusion: This study shows that elderly CHF patients can adapt quickly, find telephone-monitoring an acceptable part of their healthcare routine, and are able to maintain good adherence for a least 12 months. © 2007.

The role of near adaptation in myopia development

Prolonged near work is associated with myopia development in children and young adults but the reason underlying this association is unknown. Two potentially important factors are the near work induced ocular adaptations of contrast and accommodative adaptation. This study measured the degrees of contrast and accommodative adaptation during and following reading in myopic and emmetropic children and young adults in Singapore, where myopia is highly prevalent. Reading caused significantly greater contrast and accommodative adaptations in myopic children and myopic young adults compared to that measured in emmetropes of comparable ages. The adaptations were greater in magnitude in children than young adults, suggesting that children are more susceptible to ocular changes induced by reading and thus are potentially at greater risk of adverse refractive outcomes from these adaptations. In addition to the magnitude of the adaptations the regression time of these adaptations, (i.e. their durations) are also important. Longer accommodative adaptation regression times were measured for myopic children than for emmetropic children. Although the regression of contrast adaptation was not measured, its duration may likewise be important. The refractive effects of both of these adaptations are likely to be cumulative across the day and this could promote myopia in susceptible individuals performing considerable amounts of near work. Whether the type of text read affected the magnitude of the adaptations was also explored. Given the high prevalence of myopia in Chinese children and the fact that Chinese text is more complicated to write than English text, it was hypothesized that Chinese text would induce greater adaptation. However, both Chinese and English text produced similar amounts of accommodative and contrast adaptation in young adult subjects. We propose that children who spend prolonged periods reading at a young age are most vulnerable to near work induced adaptations and hence near work induced myopia. Both Chinese and English texts produce these effects and we propose that these adaptations are likely to occur for all types of common reading texts.

Project-based organization as adaptation to risk and opportunity in small firms

Recent years have seen a rapid increase in SMEs working collaboratively in inter-organizational projects. But what drives the emergence of such projects, and what types of industries breed them the most? To address these questions, this paper extends the long running literature on the firm and industry antecedents of new venturing and alliance formation to the domain of project-based organization by SMEs. Based on survey data collected among 1,725 small and medium sized organizations and longitudinal industry data, we find an overall pattern that indicates that IOPV participation is primarily determined by a focal SME’s scope of innovative activities, and the munificence, dynamism and complexity of its environment. Unexpectedly, these variables have different effects on whether SMEs are likely to engage in IOPVs, compared to with how many there are in their portfolio at a time. Implications for theory development are discussed.

External orientation and business model adaptation in young and nascent firms : preliminary analysis from the CAUSSE project

Discovering factors that help or impede business model change is an important quest, both for researchers and practitioners. In this study we present preliminary findings based on the CAUSEE survey of young and nascent firms in Australia. In particular, we seek to determine an association between business model adaptation and external orientation among young and nascent firms within the random sample and amongst an oversample of high potential firms. The concept of external orientation is made operational by asking respondents whether, and to what extent, they rely on certain sources of advice and information. We find that high potential firms are more likely to have made at least some change to their business model, that greater use of external sources of advice is generally significantly associated with business model adaptation, but also that there appear to be different patterns of behaviour between the random sample and the over sample.

Energy use, indoor temperature and possible adaptation strategies for air-conditioned office buildings in face of global warming

This paper discusses and summarises a recent systematic study on the implication of global warming on air conditioned office buildings in Australia. Four areas are covered, including analysis of historical weather data, generation of future weather data for the impact study of global warming, projection of building performance under various global warming scenarios, and evaluation of various adaptation strategies under 2070 high global warming conditions. Overall, it is found that depending on the assumed future climate scenarios and the location considered, the increase of total building energy use for the sample Australian office building may range from 0.4 to 15.1%. When the increase of annual average outdoor temperature exceeds 2 °C, the risk of overheating will increase significantly. However, the potential overheating problem could be completely eliminated if internal load density is significantly reduced.

National climate change adaptation research plan : freshwater biodiversity

Climate change will alter the basic physical and chemical environment underpinning all life. Species will be affected differentially by these alterations, resulting in changes to the structure and composition of present-day freshwater ecological communities, with the potential to change the ways in which these ecosystems function and the services they provide.

ACE research briefing paper 002: learning and adaptation in the business creation process

This year marks the completion of data collection for year three (Wave 3) of the CAUSEE study. This report uses data from the first three years and focuses on the process of learning and adaptation in the business creation process. Most start-ups need to change their business model, their product, their marketing plan, their market or something else about the business to be successful. PayPal changed their product at least five times, moving from handheld security, to enterprise apps, to consumer apps, to a digital wallet, to payments between handhelds before finally stumbling on the model that made the a multi-billion dollar company revolving around email-based payments. PayPal is not alone and anecdotes abounds of start-ups changing direction: Sysmantec started as an artificial intelligence company, Apple started selling plans to build computers and Microsoft tried to peddle compilers before licensing an operating system out of New Mexico. To what extent do Australian new ventures change and adapt as their ideas and business develop? As a longitudinal study, CAUSEE was designed specifically to observe development in the venture creation process. In this research briefing paper, we compare development over time of randomly sampled Nascent Firms (NF) and Young Firms(YF), concentrating on the surviving cases. We also compare NFs with YFs at each yearly interval. The 'high potential' over sample is not used in this report.

Hessian-based affine adaptation of salient local image features

Affine covariant local image features are a powerful tool for many applications, including matching and calibrating wide baseline images. Local feature extractors that use a saliency map to locate features require adaptation processes in order to extract affine covariant features. The most effective extractors make use of the second moment matrix (SMM) to iteratively estimate the affine shape of local image regions. This paper shows that the Hessian matrix can be used to estimate local affine shape in a similar fashion to the SMM. The Hessian matrix requires significantly less computation effort than the SMM, allowing more efficient affine adaptation. Experimental results indicate that using the Hessian matrix in conjunction with a feature extractor that selects features in regions with high second order gradients delivers equivalent quality correspondences in less than 17% of the processing time, compared to the same extractor using the SMM.

Enabling USDL by tools

Fundamental tooling is required in order to apply USDL in practical settings. This chapter discusses three fundamental types of tools for USDL. First, USDL editors have been developed for expert and casual users, respectively. Second, several USDL repositories have been built to allow editors accessing and storing USDL descriptions. Third, our generic USDL marketplace allows providers to describe their services once and potentially trade them anywhere. In addition, the iosyncrasies of service trading as opposed to the simpler case of product trading. The chapter also presents several deployment scenarios of such tools to foster individual value chains and support new business models across organizational boundaries. We close the chapter with an application of USDL in the context of service engineering.

SOA approaches

As the service-oriented architecture paradigm has become ever more popular, different standardization efforts have been proposed by various consortia to enable interaction among heterongeneous environments through this paradigm. This chapter will overview the most prevalent of these SOA approaches. It will first show how technical services can be described, how they can interact with each other and be discovered by users. Next, the chapter will present different standards to facilitate service composition and to design service-oriented environments in light of a universal understanding of service orientation. The chapter will conclude with a summary and a discussion on the limitations of the reviewed standards along their ability to describe service properties. This paves the way to the next chapters where the USDL standard will be presented, which aims to lift such limitations.

Working in the Australian suburbs: Creative industries workers’ adaptation of traditional work spaces

The cultural and creative industries contribution to the economic and social sustainability of cities is a well acknowledged phenomenon which has accelerated in the era of urban renewal since the late twentieth century. The second-tier city of Brisbane, Australia was for many years considered a cultural backwater in the national context, yet its recent urban development within a short period of time has produced a city that now has all the hallmarks of a ‘creative city’. Brisbane’s transformation has been shaped by urban and cultural policies that are largely focussed around its inner-metropolitan localities, producing a growth in cultural infrastructure and the aestheticisation of inner-city precincts. However, like most Australian cities, the majority of Brisbane’s population live, and increasingly work in the suburbs. This article is based on a large research project that shows that creative industries workers are well represented across suburban localities. The article examines the policy and planning implications for creative industries located in Australian outer suburbs and the communities in which they are located.